LGV (Lymphogranuloma venereum)

LGV is short for lymphogranuloma venereum. It is an infection of the urinary tract, throat and/or rectum. LGV is caused by three different types of the bacteria Chlamydia trachomatis (serovars L1, L2, L3). It is very common in Africa, Asia, South America and parts of the Caribbean, but cases have been reported in Toronto and other developed countries, especially among men who have sex with men (MSM).

How it's spread

LGV is spread by anal, oral or vaginal sex without a condom. Transmission may also occur through unprotected fisting or fingering of multiple partners at the same time or after each other. Sharing sex toys or sharing lubricant can also spread LGV.

What are the symptoms?

LGV has three stages:

Stage one:

Symptoms can occur between three to 30 days after infection.

Small painless sore/ulcer may appear at the site of infection (in the rectum, penis, vagina or mouth.)

Initial symptoms may go unnoticed if the sore is in a place that is not visible.

Sore may heal and patients may be asymptomatic until the secondary stage.

Stage two:

Symptoms can occur between two to six weeks after the primary sore heals.

Fever, chills, muscle pain, headaches, and fatigue.

Painful lumps in the groin (lymph nodes), on one or both sides. If infection is in the throat, the person may have swollen lymph nodes in the neck.

Drainage from lymph nodes in the groin.

Stage three:

Occurs in 25 per cent of patients.

More common in people who receive anal sex.

Symptoms include rectal pain or discomfort and rectal bleeding with or without rectal discharge, constipation or diarrhea.

How is it diagnosed?

The most common means of detecting LGV is through a blood test and a swab of the infected site (urethral, rectal or vaginal).

What are the complications?

Untreated, LGV can cause chronic draining and scarring, elephantiasis (swollen legs), and/or scrotal and penile swelling. In others, is can also cause salpingitis (inflammation of the uterine tubes), infertility and scarring of the labia.

How is it treated?

LGV is treated with antibiotics. It is important that you take all the pills as directed, even if the symptoms have disappeared.

What about my sexual partner(s)?

All sexual partners within the past two months should be examined and treated. They should be treated even if their test result is negative. If your partners do not have symptoms, it is still possible they have LGV.

Follow-up

Individuals should follow up with their doctor until symptoms have resolved. Do not have oral, vaginal or anal sex (even with a condom) while you and your partner are being treated.

Prevention

Using a condom every time you have sex will greatly reduce your chances of getting LGV and other sexually transmitted infections. Wash or cover sex toys in a new condom, but it is best to not share sex toys. If you are fisting someone, wear latex gloves and do not share lubricant.